Rubella, also called German measles, is a viral illness that is spread from
person to person by breathing in droplets of respiratory secretions exhaled by
an infected person. It also may be spread by touching the nose or mouth after a
persons hands have been in contact with secretions (such as saliva) of an
infected person.

How common is rubella?

Rubella and congenital rubella syndrome, a condition that affects newborn
infants when the mother transfers rubella to the baby, became nationally
reportable diseases in 1966. Prior to this, epidemics were occurring every six
to nine years. Following vaccine licensure in 1969, no further large epidemics
have occurred, and the number of U.S. cases has dropped annually from 58 per
100,000 in the pre-vaccine era to 0.5 per 100,000 by 1983. Since 1994, the
disease has occurred predominately among persons 20 to 39 years old; most of
these persons were born outside the U.S. in areas where rubella vaccine is not
routinely given. The decrease in rubella cases has paralleled s increased
efforts to vaccinate susceptible adolescents and young adults, especially
women.

Outbreaks continue to occur among groups of susceptible persons who
congregate in locations that increase their exposure, such as workplaces, and
among persons with religious and philosophic exemption to vaccination. Several
recent outbreaks have occurred among Hispanic persons. In fact, in 1996,
two-thirds of reported cases were among Hispanics.

What are the symptoms of rubella?

Symptoms of rubella include an acute onset of rash (small, fine pink spots)
that starts on the face and spreads to the torso, then to the arms and legs,
with low-grade fever, swollen lymph nodes or conjunctivitis. Many (25 percent
to 50 percent) cases are asymptomatic, especially in children, but adults may
experience symptoms for one to five days. Incubation is normally 16-18 days,
but can be 12 -23 days. Persons with rubella are infectious from seven days
before rash onset to seven days after rash onset.

Rubella can be especially dangerous to pregnant women, who may transfer
infection to the baby, resulting in abortions, miscarriages, stillbirths and
severe birth defects. The most common congenital defects are cataracts and
other eye defects, heart defects, sensorineural deafness, mental retardation
and other immunodeficiencies.

Should a person with rubella stay home?

The disease is most contagious when the rash is erupting. In schools and
other educational institutions, exclusion of persons without valid evidence of
immunity and persons exempted from rubella vaccination because of medical,
religious or other reasons should be enforced and continue until two weeks
after the onset of rash of the last reported case in the outbreak setting. In
medical settings, mandatory exclusion and vaccination of adults should be
practiced.

What is the treatment for rubella?

Treatment includes bed rest, lots of fluids and medicine for fever, headache
or joint pain. Antibiotics neither cure nor prevent rubella. There are no
antiviral drugs for treating rubella.

Can rubella be prevented?

The best prevention against rubella is immunization.The rubella vaccine is
part of the MMR (measles, mumps, rubella) vaccine administered to children
beginning at 12 months of age. Susceptible hospital personnel, volunteers,
trainees, nurses, physicians and all persons who are not immune should be
vaccinated against rubella. Women who are pregnant or intend to become pregnant
within three months, however, should not receive rubella vaccine.